Oncology-Specific Electronic Medical Records Improve Patient Care and Safety at The Mount Sinai Hospital
A majority of clinicians at Mount Sinai using electronic medical records for cancer treatment, believe the system improves patient care quality and safety.
A majority of clinicians at The Mount Sinai Hospital using Epic's Beacon module, an electronic medical record (EMR) system designed specifically for cancer treatment, believe the system improves patient care quality and safety. The data was gathered in a survey developed by Epic and administered by Mount Sinai in November 2012, eight months after Beacon was successfully implemented. Lead researcher Kerin Adelson, MD, Assistant Professor of Medicine at Mount Sinai School of Medicine presented the survey results at the ASCO Quality Care Symposium (http://quality.asco.org/) on December 1, 2012 at 12:30 pm PST in San Diego.
The use of EMRs allows for drugs to be prescribed and health records to be exchanged electronically. Quality-related clinical data also can be captured for analysis. The Beacon module enables clinicians to chart evidence-based treatment plans and provides the capacity to store a database of approved treatment protocols, including supportive care for side effect management.
To take advantage of the database feature, Mount Sinai created a council of experts, including oncology physicians, nurses and pharmacists, who spent more than a year and hundreds of hours clinically validating more than 400 treatment protocols. The council then grouped the protocols by cancer type and noted which supportive care treatments, such as anti-nausea medication, paired well with each protocol.
The Mount Sinai team found that nearly 80 percent of people using Beacon felt the system increased their day-to-day efficiency and improved the quality of patient care.
"Treatment plans and chemotherapy cycles for cancer patients are complicated, requiring multiple medications given at various intervals. Each patient's complex schedule needs to be planned out over a course of six to 12 months," said Randall Holcombe, MD, Professor of Medicine, Division of Hematology and Medical Oncology and Director of Clinical Cancer Affairs for The Mount Sinai Medical Center. "The Beacon system makes that long-term plan available to any member of the patient's medical team, and automatically adjusts a patient's schedule when the treatment plan is modified."
Storing a patient's medical information in one secure electronic location accessible to any of their clinicians creates a number of benefits. Most importantly, Mount Sinai clinical leadership may enter evidence-based treatment protocols for their care practitioners to follow, which include supportive care for side effect management. EMRs also decrease the possibility of notes or test results being misplaced, reduce orders for duplicate tests, and vets prescribed drugs and doses in each patient to prevent life-threatening medication errors.
"The major takeaway from our Beacon implementation is the opportunity to continuously improve and update treatment plans based on published research and guidelines for all practitioners to follow," said Dr. Adelson. "Ultimately, it allows us to provide higher quality, more comprehensive care to individuals by identifying the most appropriate treatment course while minimizing side effects." Dr. Adelson is the only medical oncologist in New York State to participate in the Greater New York Hospital Association/United Hospital Fund clinical quality fellowship.
Mount Sinai installed the first phase of Epic Beacon in March 2012 in the chemotherapy infusion suites and then expanded to inpatient and ambulatory services over the course of four months.
"Mount Sinai is among the top medical institutions in the country leading the way in the EMR revolution. The successful implementation of Epic's Beacon module demonstrates Mount Sinai's continued commitment to using cutting edge information technology systems to elevate quality care and patient safety," said Kumar Chatani, Senior Vice President for Information Technology and Chief Information Officer at The Mount Sinai Medical Center.
The Mount Sinai Hospital has invested $100 million in its transition to electronic medical records. In November 2011, Mount Sinai received "Stage 6" designation from HIMSS Analytics, the second-highest designation on a scale evaluating hospitals' commitment to fully incorporating health information technology into every aspect of clinical care. Mount Sinai is actively pursuing reaching "Stage 7." HIMSS Analytics is a wholly owned not-for-profit subsidiary of the Healthcare Information and Management Systems Society (HIMSS) that collects and analyzes healthcare data related to IT processes and environments. That includes products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions.
In July 2012, Mount Sinai was named to the "Most Connected" list by U.S. News & World Report, as a national medical institution recognized for clinical excellence that is also at the forefront in the use of digital technology. Mount Sinai placed higher on the list than any other hospital in the New York City metropolitan area.
About The Mount Sinai Medical Center
The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Mount Sinai School of Medicine. Established in 1968, Mount Sinai School of Medicine is one of the leading medical schools in the United States. The Medical School is noted for innovation in education, biomedical research, clinical care delivery, and local and global community service. It has more than 3,400 faculty in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National Institutes of Health (NIH) funding and by U.S. News & World Report.
The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation's oldest, largest and most-respected voluntary hospitals. In 2012, U.S. News & World Report ranked The Mount Sinai Hospital 14th on its elite Honor Roll of the nation's top hospitals based on reputation, safety, and other patient-care factors. Mount Sinai is one of 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and by U.S. News & World Report and whose hospital is on the U.S. News & World Report Honor Roll. Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place.